technetium-tc-99m-medronate and Pulmonary-Embolism

The real place of isotopic imaging in intensive care patients remains still unclear. This review aimed to consider the indications of isotopic imaging for improved diagnosis and therapy and to specify its place among the other techniques of exploration. Pulmonary perfusion and ventilation scintigraphies are valuable for the diagnosis of pulmonary embolism (PE). A "high probability" scintigraphy of the lungs ascertains the diagnosis of PE and allows to start a specific treatment without requiring a pulmonary angiography. This is not the case in the presence of a history of previous PE or if the arguments for a PE are only weak. A normal lung scintigraphy eliminates the diagnosis of a clinically significant PE all the more as an exploration of good quality of the lower limb veins remains negative. In the opposite a "non diagnostic" scintigraphy justifies a pulmonary angiography in intensive care patients. The diagnosis of myocardial contusion is made uneasy as the clinical symptoms, the ECG, the cardiac enzymes and the chest X-ray are only of limited value. Isotopic explorations of the heart could provide additional valuable data or be an alternative for 2 D echocardiography. The comparison of CPK-MB concentrations with a myocardial scintigraphy using thallium 201 is given as being very reliable, with positive and negative predictive values higher than 80%. An exploration restricted to the cardiac ejection fractions is only of limited value. In the future, an improvement will perhaps be obtained with tracers such as MIBI labelled with technetium 99m, which allow the simultaneous assessment of myocardial perfusion and the ventricular ejection fractions as well. The localisation of centres of infection, especially when intra-abdominal, remains difficult in intensive care patients. Isotopic imaging, especially the scintigraphies with labelled polynuclears, could allow in combination with conventional imaging techniques (computed tomography and 2 D echocardiography) to prevent from errors in diagnosis. An array of arguments is essential for ascertaining the presence of an abscess. Scintigraphies with leucocytes labelled with indium 111 or technetium 99m are qualified as having a sensitivity and a specificity greater than 90%. The conventional techniques of measurement of the cerebral blood flow (CBF) using xenon 133 require a special equipment or are invasive. Other cerebral tracers, such as cyclic amines (HMPAO) labelled with technetium 99m and administrable b

Topics: Acute Kidney Injury; Cerebrovascular Circulation; Critical Care; Decision Trees; Gallium Radioisotopes; Humans; Indium Radioisotopes; Infections; Myocardial Ischemia; Pulmonary Embolism; Radionuclide Imaging; Technetium Tc 99m Medronate

After left lower lobe lobectomy for lung carcinoma, a patient had acute respiratory failure secondary to pneumonia and pulmonary embolism requiring a ventilator. Tc-99m HMDP bone scan showed diffuse, intense hepatic uptake. Concurrent liver enzymes indicated hepatic necrosis. Two weeks later the patient died and a limited chest autopsy confirmed acute adult onset respiratory distress syndrome. Etiologic factors of massive hepatic necrosis in relation to hepatic localization of bone imaging agent and its prognostic outcome are discussed.

Topics: Aged; Bone and Bones; Humans; Hypoxia; Liver; Lung Neoplasms; Male; Necrosis; Postoperative Complications; Pulmonary Embolism; Radionuclide Imaging; Respiratory Distress Syndrome; Respiratory Insufficiency; Technetium Tc 99m Medronate

The aim of the study was to assess the efficacy of technetium 99m-methyl diphosphonate (Tc-MDP) and technetium 99m-methoxyisobutylisonitrile (Tc-MIBI) as radioaerosol alternatives to technetium 99m-diethylenetriaminepentacetate (Tc-DTPA) in the evaluation of pulmonary thromboembolism, as the direct consequence of the possible outcome could be cost saving.. Patients referred to our institution from August 2015 to July 2017 for a ventilation-perfusion scan who fulfilled the inclusion criteria were enrolled into the study as participants. Each ventilation agent was used to ventilate 43 participants, making a total of 129 participants in the study. Images were assessed for quality and alveolar clearance qualitatively and semiquantitatively correspondingly by a nuclear medicine physician blinded to the agent used.. Tc-MIBI had higher count rates than Tc-DTPA and Tc-MDP, with a statistically significant difference when compared with Tc-DTPA (P=0.021). Tc-MIBI clearly showed slower alveolar clearance when compared with the clearance of Tc-DTPA (P≤0.0001) and Tc-MDP (P≤0.001). In terms of image quality, Tc-MIBI generally had better quality images as compared with the other two radioaerosols, with a statistically significant difference when compared with Tc-DTPA (P=0.001).. Tc-MIBI had superior image quality and slower alveolar clearance when compared with Tc-DTPA. Alongside Tc-MDP, these agents can replace Tc-DTPA whenever clinically and economically applicable.

Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Lung; Male; Middle Aged; Prospective Studies; Pulmonary Embolism; Pulmonary Ventilation; Radionuclide Imaging; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Young Adult

Topics: Bone Neoplasms; Diphosphonates; Female; Humans; Hypercalcemia; Lung; Middle Aged; Pulmonary Embolism; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Bone and Bones; Bone Neoplasms; Diphosphonates; Fibula; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Osteosarcoma; Pulmonary Embolism; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate